Public Reporting for Coronary Artery Bypass Graft Surgery: The Quest for the Optimal Scorecard

Authors

Hiba Ghandour
Aaron J Weiss
Mario Gaudino
Michael Halkos
Danny Chu
Bradley S Taylor
John Puskas
Deepak L Bhatt
Marco Zenati
John Stulak
Todd Rosengart
Husam H Balkhy
Eugene H Blackstone
Lars G Svensson
Faisal G Bakaeen
Ozgun Erten
Tara Karamlou
Edward G Soltesz
A Marc Gillinov
Anthony Warmuth
Eric E Roselli
Nicholas G Smedira

Language

English

Publication Date

9-1-2023

Journal

The Journal of Thoracic and Cardiovascular Surgery

DOI

10.1016/j.jtcvs.2022.01.051

PMID

35525802

Abstract

Objective: A number of publicly available rating algorithms are used to assess hospital performance in coronary artery bypass grafting (CABG). However, concerns remain that these algorithms fail to correlate with each other and inadequately capture the case complexity of individual center practices.

Methods: Composite star ratings for isolated CABG from the Society of Thoracic Surgeons public reporting database were extracted for 2018-2019. U.S. News & World Report Best Hospitals was used to extract CABG ratings as well as overall cardiology and heart surgery ranking, and the Centers for Medicare & Medicaid Services Hospital Compare was used to extract CABG volume and 30-day mortality. Spearman correlation coefficients were used to assess possible relationships. Expert opinion on risk adjustment and program evaluation was incorporated.

Results: Correlations between Society of Thoracic Surgeons star rating and U.S. News & World Report overall ranking in cardiology and heart surgery (r = 0.15) and Centers for Medicare & Medicaid Services 30-day mortality (r = -0.27) were poor. Society of Thoracic Surgeons star rating correlated weakly with U.S. News & World Report CABG ratings (r = 0.33) and with Centers for Medicare & Medicaid Services CABG volume (r = 0.32), whereas the latter 2 correlated moderately (r = 0.52) with each other. Of the 75 centers with accredited cardiac surgery training programs, 13 (17%) did not participate in Society of Thoracic Surgeons public reporting. Important gaps were identified in risk assessment, and potential solutions are proposed.

Conclusions: Correlations between current CABG public reporting systems are weak. Further work is needed to refine and standardize CABG rating systems to more adequately capture the scope and complexity of an individual center's clinical practice and to better inform patients.

Keywords

Humans, Aged, United States, Medicare, Coronary Artery Bypass, Cardiac Surgical Procedures, Hospitals, Risk Adjustment, STS star rating, U.S. News & World Report, cardiac surgery, health policy, multiarterial grafting, public reporting, quality metrics

Published Open-Access

yes

Recommended Citation

Ghandour, Hiba; Weiss, Aaron J; Gaudino, Mario; et al., "Public Reporting for Coronary Artery Bypass Graft Surgery: The Quest for the Optimal Scorecard" (2023). Faculty and Staff Publications. 4946.
https://digitalcommons.library.tmc.edu/baylor_docs/4946